Mid-week update

The partial shutdown continues. Roll Call reports that the backpay bill for furloughed federal employees has run into a snag at the Senate. Govexec.com reports that many agencies, e.g. State Department, federal courts, are operating on unused fiscal year 2013 appropriations which could run out soon leading to "thousands" of more furloughs.

Here are some interesting developments on the benefit design front:

• Aon Hewitt reports that consumer driven plans continue to grow in popularity among employers. This trend will continue as we inch toward the 2018 date for implementation of the ACA's Cadillac tax. 
• Aetna released a report on the success of its dental integration program:

The DMI program uses technology to automatically identify members with diabetes, cardiovascular disease, or who are pregnant. Members with those medical conditions who have not recently seen the dentist receive education by mail and phone on the importance of regular dental care. Aetna dental coordinators are available to help DMI members choose a dentist and schedule an appointment. DMI members qualify for enhanced dental benefits such as an extra cleaning and periodontal services covered at 100 percent to help prevent more serious and costly issues. The enhanced dental benefits are not subject to deductible or coinsurance and do not count toward annual plan maximums. There is no added cost to members or plan sponsors for the DMI program.

• Modern Healthcare reports that 

 A group of large employers including retail giants Wal-Mart Stores and Lowe's Cos. announced they will offer their employees coverage for hip and knee implant procedures with no cost-sharing if they receive the procedures at one of four previously selected hospital systems.

The participating hospitals are Johns Hopkins Bayview Medical Center in Baltimore; Kaiser Permanente's Orange County-Irvine (Calif.) Medical Center; Mercy Hospital Springfield (Mo.); and Virginia Mason Medical Center in Seattle.

The preferred network is similar in many ways to initiatives developed by Wal-Mart and Lowe's that encourage employees to visit preferred academic centers like the Cleveland Clinic and Mayo Clinic for heart and spine surgeries.

In the same vein, Kaiser Health News reports on steps that health systems are taking to better manage high utilizers.